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Interview with Dr. Lloyd Kasper on the pathogenesis of MS
Interview with Dr. Lloyd Kasper, professor of medicine and microbiology/immunology at the Geisel School of Medicine at Dartmouth in Hanover, N.H. during AAN 2015 on the importance of the gut microbiome in the pathogenesis of multiple sclerosis.
As a mucosal immunologist, Dr. Kasper has studied the role of the immune system in the pathology of many human diseases. Animal research showed that germ-free mice could not develop experimental autoimmune encephalitis (EAE), a multiple sclerosis (MS)-like disease. When these mice were colonized with bacteria normally found in the human gut, they went on to develop EAE. This suggested a potential role for the gut microbiome in MS.
Most risk factors for MS are influenced by the gut microbiome and there is a bidirectional system between the brain and the intestinal flora. Potential emerging therapeutics include probiotics or even fecal transplant. In patients with inflammatory bowel disease that developed C. dificille infection, fecal transplants help to recolonize the gut with healthy bacteria. The human gut microbiome has thousands of different types of bacteria.
B. fragilis is a very common gut microbiota. A molecule from bacteria was purified and could prevent disease in animal models of MS. Preliminary studies in human blood samples has shown good immune responses, including an increase in regulatory T cells.
The exploration of the human microbiome is only beginning to be explored, more research is needed to unlock the potential of this system. Targeting the human microbiome may also have clinical applications in treating everything from obesity to cancer. It is important to consider that the gut microbiome does not only include the microbiota, but the genomic make-up of those organisms along with the interaction with the human genome. Understanding these interactions will help to unlock the potential of the gut microbiome in treating human disease.